Several studies indicate that dental fluorosis prevalence has increased over the last 40 years and that the increase is more pronounced in non-fluoridated areas. Dental fluorosis is clearly associated with an excessive intake of fluoride. The contribution of fluoride from multiple sources, and the risks associated with these exposures, have attracted considerable attention. The overall objective of this study is to determine if children in fluoridated and non-fluoridated cities are being exposed to excessive amounts of fluoride as evidenced by an increase in the extent of severity of dental fluorosis. This cross-sectional study will be the fourth in a series of surveys intended to draw inferences about changing patterns of dental fluorosis and dental caries over time in the historical cities of Newburgh and Kingston. Clinical examinations on a sample of 3,000 seven to fourteen year old children in fluoridated Newburgh and 1600 children in non-fluoridated Kingston will be conducted. Data on frequency and severity of dental fluorosis will be collected using Dean's Index. Appropriate comparisons will be made to assess whether the occurrence of fluorosis has increased or decreased when compared to the data obtained in 1986. Trends in dental caries prevalence in Newburgh and Kingston will also be assessed. The association of fluoride tablet/drops history and dental fluorosis will be explored. This study will provide new information regarding the impact of recommendations implemented in recent years to lower fluoride intake from supplements and infant formula. The long-term objective is to conduct follow-up examinations after 36 months for comparing caries incidence rates as well as to detect changes in fluorosis severity within subjects.